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Background: Childhood urinary tract infections (UTIs) are among the most prevalent diseases. In recent years, the overuse of common antibiotics has increased antibiotic resistance among urinary tract pathogens worldwide, with changes in the pattern of microbial resistance varying by geographical area and time. Objectives: This study aims to investigate the pattern of microbial resistance of UTI pathogens in pediatric patients. Methods: In this cross-sectional study, children aged < 13 years with UTI and positive urine cultures, who were admitted to Bahrami Hospital in Tehran, Iran, between 2015 and 2019, were evaluated. The pathogens' frequency, their antimicrobial resistance, and clinical and demographic information were extracted from the patients' files. Statistical relationships between clinical and demographic data and antibiotic resistance were analyzed using appropriate statistical tests. Results: The files of 202 patients were evaluated. The majority of patients were female (79.2%). UTI was more common among the 12 - 60 months age group (36.3%) in females and the 1 - 12 months age group (50%) in males. The most common UTI pathogen was Escherichia coli (85.1%). The lowest rates of microbial resistance were related to Meropenem (0% resistance), Gentamicin (9.2%), and Amikacin (10.8%). Conversely, the highest resistance rates were observed for Cotrimoxazole (74.6%), Ampicillin (74.5%), and Cephalothin (64.9%). Conclusions: UTI is more common in females aged 1 to 60 months. E. coli is the most common cause of UTI. Microbial resistance to antibiotics used for empirical treatment, such as ceftriaxone, is high and changes over time. It is recommended to use alternative antibiotics and avoid the inappropriate administration of antibiotics. [ABSTRACT FROM AUTHOR]

Little is known about using noninvasive samples for diagnosing Crimean-Congo hemorrhagic fever (CCHF). We investigated detection of CCHF virus in serum, saliva, and urine samples. Our results indicate that serum is the best sample type for CCHF diagnosis; saliva can be used for noninvasive sampling. [ABSTRACT FROM AUTHOR]

Polycyclic aromatic hydrocarbons (PAHs) are one of the most important environmental pollutants. Urinary concentrations of 1-hydropyren metabolites of PAHs have been used as biomarkers of these chemicals' exposure in humans. This cross-sectional study was conducted on 468 healthy Iranian adults over 25 years old and non-smokers in six provinces who were selected based on the clustering method. Fasting urine sampling and body composition and demographic measurements were performed. Urine samples were analyzed by GC-MS. The analysis included descriptive statistics and analytical statistics using multiple linear regression by Python software. 1-Hydroxypyrene was found in 100% of samples, and the mean (Reference Value 95%) concentration of 1-hydroxypyrene was 6.12 (RV 95%: 20) μg/L and 5.95 (21) μg/gcrt. There was a direct relationship between the amount of body composition (body fat, visceral fat), BMI, and age with the urinary concentrations of 1-hydropyren metabolites, and this relationship was significant for BMI with urinary concentrations of 1-hydropyren metabolites (P = 0.045). The amount of 1-hydroxypyrene in healthy Iranian adults has been higher than in similar studies in other countries. These results provide helpful information regarding the exposure of Iranian adults to 1-hydroxypyrene, and these data can be used to supplement the national reference values of human biomonitoring for the interpretation of biomonitoring results. [ABSTRACT FROM AUTHOR]

Background: Urinary tract infections (UTIs) are among the most common bacterial infections in children. Urinalysis (UA) is a beneficial test for the preliminary diagnosis of UTIs. The presence of bacteriuria in UA can be determined by either an enhanced (using uncentrifuged Gram-stained specimens) or manual (using centrifuged specimens) technique. However, the diagnostic performance of enhanced UAis not well-established in childhood UTIs. Objectives: To assess the ability of enhanced and automated urinalysis to detect UTIs in children. Methods: This cross-sectional study was conducted on 191 children with the symptoms of UTI referred to Dr. Sheikh Hospital, Mashhad, Iran, from 2018 to 2019. Standard urinalysis, enhanced urinalysis, and quantitative urine culture were performed on specimens. A positive enhanced UA test was defined as ≥ 10 white blood cells per mL of urine and the presence of any bacteria per 10 high-power microscopic fields of a Gram-stained smear. A positive manual UA test was defined as ≥ 5 white blood cells per high-power field. The results of standard and enhanced UA were compared with urine culture findings to determine the accuracy of these two methods in detecting UTIs. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were determined for each test. Results: The results showed that the prevalence of UTI was 23%. Enhanced UA retrieved a sensitivity of 97.7%, specificity of 93.1%, PPV of 81.1%, and NPV of 99.3% for detecting UTIs. In standard UA, sensitivity, specificity, PPV, and NPV were 90.9%, 80.7%, 57.1%, and 96.6% for pyuria, 56.8%, 98.6%, 92.5%, and 88.4% for the nitrite test, 72.7%, 94.5%, 80%, and 92% for the leukocyte esterase test, respectively. Conclusions: Enhanced UA had higher sensitivity, specificity, PPV, and NPV than standard UA. [ABSTRACT FROM AUTHOR]

Febrile convulsion (FC) is the most prevalent type of seizure in children. Febrile diseases have been associated with alterations in kidney function and urine indices. Therefore, in this study, renal function and urine analysis were examined in children with simple FC. The study comprised children with simple FC who were referred to the Amirkabir hospital in Arak between 2020 and 2021. Children were examined for urinalysis and kidney function by assessing the estimated glomerular filtration rate (eGFR). A total of 157 patients with FC were admitted. Hematuria, proteinuria, and pyuria were detected in 8.9%, 1.9%, and 5.1% of cases, respectively. The urine cultures of 2 children were positive. Moreover, it was found that in simple FC, eGFR decreases regardless of gender (P >.05), although kidney function decreases more in children older than 24 months. In conclusion, all children with FC must undergo renal function assessments. Furthermore, urinalysis and urine culture are advised to rule out infection. [ABSTRACT FROM AUTHOR]

Background & Aims: Leptospirosis is a common infectious disease between humans and animals, which is of particular importance in terms of global spread. The cause of the disease is Leptospira bacteria. This bacterium is gram-negative and spiral-shaped and belongs to the Leptospiraceae family and the Spirochetes branch (1,2). The genus Leptospira is divided into 20 species (9 pathogenic, 5 intermediate and 6 saprophytic) based on phylogenic and DNA analysis. Saprophytic species (eg L. biflex). Leptospira species cause a common disease called leptospirosis. Leptospira settle in the kidney tubules of animals (susceptible mammals) and because of this the host animals remain infected for a long time and expel the bacteria (7). Livestock (cows and sheep) are sources of leptospirosis and should be taken care of to prevent transmission of the disease to humans (8,9). Leptospira species remain in the environment for a long time, transfer to humans through damaged skin and mucous membranes, mortality and economic losses are considered as an important global health issue (2,7,10). Every year, half a million cases of leptospirosis (45 cases per 100,000 people) are reported worldwide (11). Leptospirosis is more common in hot seasons and in tropical and rainy regions of the world (11,12). The incubation period of leptospirosis in humans is about 10 days and may be asymptomatic (12). The clinical face of this disease is so variable that it is considered as a disease with a thousand faces and it can never be diagnosed based on clinical signs and symptoms alone, so diagnosis is more based on trusting the laboratory in showing and observing the cause of the disease. And the accuracy of laboratory methods is stable. Definitive diagnosis of leptospirosis is based on laboratory tests such as bacterial culture, ELISA test, MAT and PCR (16), which is the standard serological method for identifying leptospirosis antibodies according to the World Health Organization (WHO) Microscopic agglutination test (MAT), which is a method It is cheap with acceptable sensitivity and it is possible to access it (17) and it shows the wide presence of Leptospira in the world (16). Bacteremia develops within 7-10 days after symptoms of infection by Leptospira and antibodies can be detected in the blood (18,19). The aim of the present study was to investigate leptospirosis seroepidemiologically among the farmers of Kohdasht in Lorestan province by microscopic agglutination method (MAT) and also to determine and obtain the serovars infecting people in Kohdasht region. The results obtained from the present research can provide a lot of help to researchers in medical and veterinary sciences of the country, and it is also very useful in human and animal health and rapid diagnosis and treatment of patients. Methods: The study was conducted on the blood samples of 200 cattle farmers of Kohdasht in February 2013. After selecting the livestock farms, he went to the livestock farm and took 10 cc of blood samples from the hand veins of the people who were active in livestock farming. After the complete collection of samples, microscopic agglutination test (MAT) and measurement of serum contamination were performed to determine the contamination of serum samples with Leptospira serovars on blood serum samples. The results obtained from the MAT method were analyzed with SPSS software (Version 16) through Chi-square and Fisher's test. P<0.01 was considered as significant difference. Results: 48 serum samples (24%) were positive among 200 tested sera at the 1:100 dilution. Serum samples were shown positive reaction with two L. Grippotyphosa and L. canicola serovars. The prevalence of Grippotyphosa 66.67% and Canicola 33.33% were resulted by MAT. 31 samples (64.58%) were related to males and 17 cases (35.42%) females among 60 positive samples. The highest prevalence of Leptospira serovars was founded in more than 50 years group with 16 cases. P. value based on gender was 0.01. (p<0.01). Conclusion: Leptospira pathogenic species can survive for a long time under suitable environmental conditions (humidity and temperature). Domestic animals (cows, sheep and dogs) are considered important as hosts of this bacterium in the spread of leptospirosis and play a significant role (20). Leptospira is released into the environment through the urine of animals. Human infection with leptospirosis is caused by contact with the urine of infected animals (21). Diagnosis of leptospirosis is difficult for many doctors, and its definitive diagnosis is possible with laboratory methods. The MAT method is universally used as a reference test for the diagnosis of leptospirosis. In the present study, the prevalence of leptospirosis among farmers in Kohdasht was 24%, and the serovars Gripotiphosa and Canicula had the highest prevalence, respectively. The P value of p<0.01 was significant for gender and showed that leptospiral infection is different according to gender. All over the world, studies on the prevalence of leptospirosis have been carried out. In Iran, in 2004, the prevalence of leptospirosis in Gilan University Hospital was reported by Honarmand et al. to be 24.6% (22). In 2016, in a serological study of leptospiral infection of sheep using the MAT method in Ahvaz, Hajikolaei et al. reported the occurrence of 14.9% leptospirosis and the highest number of leptospirosis serovars was related to Pomona with 14 cases (43.8%), respectively. canicula with 7 cases (21.9%) and ictrohemorrhage with 4 cases (14.5%) (23). This study showed that transmission of leptospirosis is carried out by sheep as hosts, so livestock farmers are prone to leptospirosis. A study was conducted on dairy cows in Hamedan industrial farms in 2009 by Bahari et al., out of 80 blood samples, 18 were positive for Leptospira and the highest serovar prevalence was Canicula (21.25%) (24). This study is another proof of the susceptibility of livestock farmers to leptospirosis. In 2008, Agampodi et al. conducted a study on 404 patients with fever in Sri Lanka using the MAT method, of which 155 patients were found to have leptospirosis. In this study, the prevalence of serovars Pyrogenesis (28.7%) and Hardjo (18.8%) was reported (25). In 2012, Ngbede et al. conducted a study in Nigeria using the MAT method on 142 blood samples of cows slaughtered in a slaughterhouse, and 5 samples were found to have antibodies against Hardjo serovar (26). Goris et al. in 2013 in the Netherlands in a study they conducted on sick people concluded that serovars Ictrohemorrhagia, Hardjo, and Gripotyphosa cause severe leptospirosis in humans (27). In 2014, Dreyfus et al. used the MAT method to investigate the risk factors of leptospirosis among 567 slaughterhouse workers in New Zealand. They found that 11% of the workers had antibodies against Hardjo and Pomona serovars in their blood serum (28). Leptospirosis is related to occupation and environment (29). Floods and inundation as well as contact with animal waste are the most important factors of leptospirosis infection (30). Leptospirosis may lead to failure of liver, kidney and many organs of the body. In general, leptospirosis is spreading, so disease control should be considered. it is concluded that livestock farmers are one of the groups at risk of leptospirosis due to the presence of different leptospira serovars in animals. Livestock farmers can prevent the occurrence of leptospiral infection by controlling their safety and health. The results of this study are very useful in the research of medical and veterinary sciences as well as human and animal health and rapid diagnosis and treatment of patients and provide a lot of information to researchers in disease control. [ABSTRACT FROM AUTHOR]

Exposure to metal(loid)s can cause adverse health effects. This study evaluated the concentrations of aluminum, arsenic, cadmium, chromium, mercury, nickel, and lead in particulate matter <10 μm (PM 10 ) and in the urine of 100 participants from urban residential areas in Iran. A total of 100 residential buildings (one adult from each household) in six cities across Iran were recruited for this study. The levels of metal(loid)s in PM 10 and the urine of participants were measured using acid digestion followed by inductively coupled plasma mass spectrometry (ICP-MS). The average (±SE) PM 10 concentration in the buildings was 51.7 ± 3.46 μg/m 3 . Aluminum and cadmium had the highest and lowest concentrations among the metal(loid)s, averaging 3.74 ± 1.26 μg/m 3 and 0.01 ± 0.001 μg/m 3 , respectively. In 85 % of the samples, the concentration of metal(loid)s in indoor air exceeded WHO air quality standards. Cadmium and lead had the highest and lowest numbers of indoor air samples exceeding the recommended standards, respectively. A significant correlation was found between the concentration of metal(loid)s in urine samples and indoor PM 10 levels, as well as the wealth index of participants. There was also a significant direct relationship between the concentrations of nickel, arsenic, lead, and mercury in urine and the age of participants. Factors such as building location, type of cooling systems, use of printers at home, and natural ventilation influenced the concentration and types of metal(loid)s in the indoor air., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

The current study aimed to evaluate the levels of some toxic and essential elements (Pb, Cd, Cu, Ti, Ni, Cr, Co, Fe, Ca, Hg, Mn, Se, and Zn) in the urine of opium-addicted compared to non-addicted cases. In this study, 126 participants were recruited and their fasting urine samples were collected (63 opium-addicted and 63 non-addicted subjects served as the reference group). ICP-MS was utilized to detect the concentration of trace elements. Results exhibited that the concentration of all elements than Ni, Cu, and Zn was markedly different between the addicted and non-addicted groups. Compared to controls, the Cd, Cr, Co, Hg, Mn, Pb, Se, and Ti levels were higher among opium-addicted cases (p < 0.05) whereas the Fe and Ca concentrations were higher among controls (p < 0.05). Robust regression analysis showed no statistically significant effect of gender on element levels. It revealed that age was associated with the levels of Ni and Cu only and also the route of administration was related to the urinary levels of Co, Cr, Hg, and Mn. In conclusion, results confirmed that it is opium consumption that affects the concentration levels of most elements. [ABSTRACT FROM AUTHOR]

Background: This study measured the concentrations of arsenic (As), aluminum (Al), cadmium (Cd), chromium (Cr), mercury (Hg), nickel (Ni), and lead (Pb) in the urine samples of the Iranian adult population., Methods: This nationally representative study was conducted on 490 participants in six provinces of Iran who were selected based on the clustering method. Participants included healthy Iranian adults aged above 25 years without a history of illness and non-smokers. Fasting urine sampling, body composition, and demographic measurements were performed for each participant. Urine samples were analyzed by acid digesting method using Inductively Coupled Plasma Mass Spectrometry (ICP-MS). The analysis included descriptive statistics and multiple linear regression using Python programming language., Results: The geometrical mean (with corresponding reference values, µg/l) concentrations of metal(loid)s in urine for women, men, and both were 198.2 (625.3), 163.5 (486.1), and 192.5(570.4) for Al, 15.6(51.7), 28.8(71.1), and 21.9 (61.64) for As, 18.5(55.2), 20.7(56.5), and 19.22(55.75) for Pb, 17.9(57.6), 17.9 (53.9), and 17.9(56) for Ni, 13.95(47.5), 20.3(62.2) and 16(51.6) for Cr, 3.5(12.2), 2.9(11.5), and 3.3(12) for Hg, 0.74(2.7), 0.95 (3.6), and 0.81(3.1) for Cd. There was a direct relationship between the concentration of metal(loid)s and demographic indicators and body composition (P<0.05). Moreover, there was a direct relationship between the concentration of As, Cr, Hg, Ni, and Pb with age and wealth index (P<0.05)., Conclusions: The concentrations found could be used as the reference range for As, Al, Cd, Cr, Hg, Ni, and Pb for human biomonitoring studies on the Iranian adult population., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier GmbH. All rights reserved.)

Folliculorum mites (Demodex folliculorum, and D. brevis) are part of the common external parasites in humans as the exclusive host of them. The highest focus of these mites is on those parts of the body that have fat glands and fatty products in the skin. This is proven by the dermal -- epidermal separation method. In the present study, the presence of Demodex is reported in a urine sample containing hematuria, which has not been observed so far according to the previous investigations. The case was related to a 44-yr-old woman with symptoms of headache, chills, and joint pain referring to the medical diagnostic laboratory of Sanandaj, Kurdistan Province, northwest of Iran. After historiography and collecting the urine sample as middle, the live parasite of Demodex was observed. The presence or migration of mite in the atypical areas of the body (genital, urinary, eye, etc.), which are close to hairy tissues (especially in women), may be one of the causes of allergic reactions and clinical symptoms in people. [ABSTRACT FROM AUTHOR]

The concentration of polycyclic aromatic hydrocarbons (PAHs) in the air inside residential houses in Iran along with measuring the amount of 1-OHpyrene metabolite in the urine of the participants in the study was investigated by gas chromatography-mass spectrometry (GC-MS). Demographic characteristics (including age, gender, and body composition), equipment affecting air quality, and wealth index were also investigated. The mean ± standard error (SE) concentration of particulate matter 10 (PM 10) and ∑PAHs in the indoor environment was 43.2 ± 1.98 and 1.26 ± 0.15 μg/m3, respectively. The highest concentration of PAHs in the indoor environment in the gaseous and particulate phase related to Naphthalene was 1.1 ± 0.16 μg/m3 and the lowest was 0.01 ± 0. 0.001 μg/m3 Pyrene, while the most frequent compounds in the gas and particle phase were related to low molecular weight hydrocarbons. 30% of the samples in the indoor environment have BaP levels higher than the standards provided by WHO guidelines. 68% of low molecular weight hydrocarbons were in the gas phase and 73 and 75% of medium and high molecular weight hydrocarbons were in the particle phase. There was a significant relationship between the concentration of some PAH compounds with windows, evaporative coolers, printers, and copiers (p < 0.05). The concentration of PAHs in houses with low economic status was higher than in houses with higher economic status. The average concentration of 1-hydroxypyrene metabolite in the urine of people was 7.10 ± 0.76 μg/L, the concentration of this metabolite was higher in men than in women, and there was a direct relationship between the amount of this metabolite in urine and the amount of some hydrocarbon compounds in the air, PM 10 , visceral fat and body fat. This relationship was significant for age (p = 0.01). The concentration of hydrocarbons in the indoor environment has been above the standard in a significant number of non-smoking indoor environments, and the risk assessment of these compounds can be significant. Also, various factors have influenced the amount of these compounds in the indoor air, and paying attention to them can be effective in reducing these hydrocarbons in the air. [Display omitted] • The first national study of indoor PAHs exposure in Iranian adults in urban area. • The influence of Indoor equipment on concentration of PAHs in indoor air. • 1-OHpyrene and its relationship with demographic indicators and air quality. • Measurement of hydrocarbons in gaseous and particulate phase. • Classification of hydrocarbons in air based on molecular weight. [ABSTRACT FROM AUTHOR]

Background: Trichomoniasis, caused by Trichomonas vaginalis protozoan, may lead to clinical or subclinical urethritis or prostatitis in men. Despite the importance of men in the epidemiology of trichomoniasis, there is little information about this topic. This epidemiological study was performed on men in Hamedan, western Iran. Methods: During Oct 2018 to Mar 2019, 214 male individuals, presenting to the Urology Clinic of Shahid Beheshti Hospital in Hamadan, were enrolled and evaluated for trichomoniasis. First-voided urine specimen was used for detection of T. vaginalis infection using molecular and parasitological methods. Results: Trichomoniasis was detected in 10 of 214 male participants (4.7%, 95% CI: 7.5-1.8%) using PCR assay. Culture and wet mount preparation of urine sediment were unable to isolates any T. vaginalis parasite. Nine of the 10 infected men were married, and six of them were ≥49 yr of age. Urinary frequency and dysuria were the most complaints (80%) among infected individuals. Conclusion: Given the notable prevalence of the infection, the prevalence of male trichomoniasis will be underestimated if only conventional diagnostic methods are used. Therefore, the risk of infection as well as the molecular survey of T. vaginalis infection should be considered in men with or without clinical symptoms. [ABSTRACT FROM AUTHOR]

Cancer is the second leading cause of death in the world and the third leading cause of death in Iran. It has been proven that numerous cancer cases are caused by exposure to environmental pollutants. There is a public health concern regarding an increase in exposure to carcinogens across Iran through different sources (air, food, and water) and a lack of research to address this issue. This study aims to gather data on exposure to heavy metals, polycyclic aromatic hydrocarbons (PAHs), and pesticides and their intake routes during the implementation of a national population health survey. This is a cross-sectional study of environmental pollutants in Iran, with a stratified multi-stage random sampling method, which led to 660 nationally representative samples in 132 clusters in three sequential parts. The first will be questionnaires to obtain demographics, assets, food records, air quality, and food frequency. The second will be physical measurements, including anthropometric and body composition. The third will be lab assessments that measure 26 types of environmental pollutants (7 heavy metals, 16 PAHs, and 3 pesticides) in urine, inhaled air, and consumed food and water of the population under study using ICP-MS and GS-MS devices. The results of this study will inform policymakers and the general population regarding the level of threat and will provide evidence for the development of interventional and observatory plans on the reduction of exposures to these pollutants. It could also be used to develop local standards to control contaminants through the three exposure routes. This study protocol will obtain data needed for policymakers to set surveillance systems for these pollutants at the national and provincial level to address the public concerns regarding the contamination of food, air, and water. [ABSTRACT FROM AUTHOR]

Context: Heavy metals, including thallium and lead, are introduced to illicit drug users' body as a result of using drugs such as cocaine and heroin. Objective: This study aimed to determine urine, blood, and hair thallium (Tl) concentrations in illicit opioid users along with the relevant clinical signs and symptoms consistent with thallotoxicosis and to compare them with the corresponding variables in the control non-opioid user group. Materials and Methods: This case–control study was conducted on 50 illicit opioid users who had abused opioids continuously for more than a year, referred to Amirie Drug Abuse Treatment Clinic in Kashan, Iran. The control group included 50 non-opioid users. Thallium concentrations in urine, blood, and hair were assessed in both groups (n = 100) using electrothermal (graphite furnace) atomic absorption spectrometry (ET AAS, GF AAS). Results: In the studied group, the median (interquartile range) concentrations of thallium in urine, blood, and hair were 54.8 ± 79.9 μg/L, 14.5 ± 11.1 μg/L, and 5.4 ± 3.7 µg/g, respectively; these values were 4.8 ± 5.2 μg/L, 2.5 ± 2.4 μg/L, and 1.4 ± 1.1 µg/g, respectively, in the control group. There were significant differences in urine, blood, and hair thallium concentrations between the study group and the control group (p < 0.001). There were significant correlations between duration of illicit opioid use and urine thallium concentrations (r = 0.394, p = 0.005) and hair thallium concentrations (r = 0.293, p = 0.039), but not with blood thallium concentrations (r = 0.246, p = 0.085). Urine and blood thallium concentrations of illicit opioid users with clinical signs and symptoms consistent with thallotoxicosis of weakness (p = 0.01), depression (p = 0.03), and headache (p = 0.03) were higher than users without these problems. Discussion and conclusion: The results of the study showed that thallium concentrations in urine, blood, and hair in illicit opioid users were significantly higher than the comparable concentrations in the control group. This can be due to the use of illicit opioids adulterated with thallium. Also, this study showed long-term illicit opioid use may lead to thallium exposure. In addition, cigarette smoking was associated with increased thallium exposure. [ABSTRACT FROM AUTHOR]

Background: Infections are one of the most important causes of death in infants, especially in developing countries. Inappropriate use and administration of antibiotics can contribute to the resistance and spread of infection. In this study, we determined the antibiotic resistance pattern of the bacteria isolated from clinical samples of blood, cerebrospinal fluid, and urine in the neonatal intensive care unit (NICU) of Ali Asghar Hospital, Iran during 2013-2015. Methods: For the purposes of the study, clinical samples of blood, cerebrospinal fluid, and urine were collected from the NICU of Ali Asghar Hospital during 2013-15. The type of bacterial strain and antibiotic susceptibility pattern was determined by routine microbiological tests. The collected data were analysed in SPSS software (version 19), using χ2, Student's t-test, and ANOVA test for comparison. Results: In total, 240 positive culture samples (118 blood, 117 urine, and 5 cerebrospinal fluid samples) were collected for this research. The most common isolates in the blood, urine, and cerebrospinal fluid samples were Staphylococcus epidermidis (63.6%), Klebsiella (35%), and Acinetobacter Baumannii (40%), respectively. The highest antibiotic resistance in S. epidermidis isolated from blood samples was found against amikacin and cefotaxime, while linezolid and vancomycin were the most effective antibiotics against S. epidermidis. Moreover, ciprofloxacin and nitrofurantoin were the most effective antibiotics against Klebsiella isolated from urine samples, while this bacterial strain had the highest resistance to imipenem and ampicillin. Despite the fact that A. Baumannii strains were resistant to most studied antibiotics, ceftazidime and ceftriaxone had an acceptable antibacterial effect against these isolates. Conclusion: Continuous surveillance for antibiotic susceptibility, rational use of antibiotics, and the strategy of antibiotic cycling can provide some answers to the emerging problem of antibiotic resistance. [ABSTRACT FROM AUTHOR]

Background: Prolonged exposure to crystalline silica (CS) (SiO2) dust enhances the production of reactive oxygen species. In many studies, oxidative stress has been measured in the serum of workers exposed to SiO2dust. Aims: We investigated the body fluids such as urine, saliva, and serum, which can provide very good results for assessing the health status of workers' exposures to SiO2dust. Materials and Methods: The oxidative stress biomarkers were evaluated in serum, urine, and saliva of 21 workers who were exposed to SiO2silica crushing factories in the Hamadan city at the west of Iran as a case group and 28 controls. Results: The level of malondialdehyde in serum, urine, and saliva was significantly higher than that in case group compared to controls (22.19 ± 8.70, 9.86 ± 5.43, and 9.41 ± 7.31 nmol/L vs. 7.30 ± 2.22, 6.79 ± 3.21, and 3.93 ± 3.73 nmol/L, respectively). In addition, the total antioxidant capacity in urine (0.23 ± 0.06 vs. 0.29 ± 0.08 mmol/L), as well as catalase in the serum and saliva of case group was lower than that compared to control group (5.46 ± 1.56 and 1.32 ± 0.55 IU/L vs. 12.55 ± 5.72 and 2.32 ± 1.53 IU/L, respectively). Conclusions: The current study indicated that chronic exposure to SiO2affects significantly on the oxidative stress biomarker levels in serum, urine, and saliva in persons exposed. Furthermore, SiO2leads to the induction of oxidative stress and decreases the activity of the antioxidant enzyme. [ABSTRACT FROM AUTHOR]

Background: The most common method of combating insects in low-income communities and developing countries, is the use of insecticides. The use of organophosphate insecticides is increasing due to their low prices and availability on the market. Chlorpyrifos is a medium-risk insecticide for human. The widespread use of organophosphorus insecticides, especially chlorpyrifos, in residential homes has undoubtedly created many health concerns. Babies have a high sensitivity to pesticides and environmental contaminants because of their evolutionary status. On the other hand, the main source of infants' exposure who are breast-fed exclusively to environmental pollutants is through breast milk and oral contact with objects that are covered with dust and particles. Methods: In this cross-sectional study, the concentration of chlorpyrifos in breast milk and its metabolite in urine samples of mothers and their under six months infants, feeding exclusively by breast milk in north of Iran have been investigated. The demographic data was collected through interviewing with selected mothers and completion of prepared data collecting forms. The data were statistically analyzed to investigate the relationships between exposure of mothers and their infants to chlorpyrifos. Results: The mean concentration of chlorpyrifos and its metabolite in mothers' urine and milk samples and infant's urines were 1.3 ± 0.6, 2.1 ± 1.4 and 1.4 ± 0.7 μg/L, respectively. Also, the mean concentration of chlorpyrifos in the dust on the house floors was73.4 ± 49 ng/g. There are good correlations between the mean values of chlorpyrifos concentrations and its metabolite in mother's milk and urine (r = 0.872, p = 0.001), and the mother's milk and infant's urine (r = 0.722, p = 0.001). Also, there was a significant correlation between the concentration of chlorpyrifos in floor dust and its metabolites in the infant's urine (r = 0.554, p = 0.001). Conclusion: Our study suggests that the infants are the recipient of concentrated forms of chlorpyrifos residues through breast milk and house dust and it is quite well known that OP pesticides are toxic and have different kinds of adverse health effects. However, further research needs to be done to determine what these chemicals are doing to our children. [ABSTRACT FROM AUTHOR]

Compact fluorescent lamps (CFLs) have become a popular lighting choice in recent years despite the good performance of light-emitting diode (LED) lamps. The CFLs that have been produced recently contain 1.5–3.5 mg Hg/lamp. There is evidence that even low doses of mercury are toxic. This study aimed to assess occupational exposure to mercury vapor in workers of a CFLs factory by determining mercury levels in personal and ambient air samples and urine of workers. This cross-sectional study was conducted on 59 workers in a CFLs factory in Iran. Personal and ambient air sampling of mercury vapor levels (MVLs) was performed during a workday. In total, 10 personal samples and 10 ambient air samples of mercury vapor were collected simultaneously from different units of the factory. Urine samples were collected before the work shift. Samples were analyzed using a cold-vapor atomic absorption spectrophotometer (CVAAS). The mean of the MVLs in the personal and ambient air samples was 14.78 ± 5.76 and 67.10 ± 59.37 µg.m−3, respectively. The highest MVL was measured for the production line supervisor (25 µg.m−3). There was a significant correlation between the MVLs in the ambient air and personal samples (r = 0.84, p = 0.005). The mean urinary mercury level (UML) was 13.85 ± 13.14 µg/g creatinine. The UML of 86.4% workers was below the 20 µg/g creatinine recommended by the Centre of Environmental and Occupational Health in Iran. There were significant differences between the UMLs in different areas of the factory (p = 0.041). Lamp breakage was an important determinant of exposure to mercury vapor; hence, effective programs to control mercury vapor are essential in the CFLs industry. [ABSTRACT FROM AUTHOR]

Introduction: Urinary tract infections are the common medical problems in pregnant women and associated bacteria produce biofilm which protects them from antibiotics. Aim of this study was to determine the pattern of antibiotic resistance and biofilm formation by Escherichia coli and Klebsiellapneumoniae isolated from urine of pregnant women in Kerman, Iran. Methods and Materials: 107 urine samples were collected from pregnant women. Identification was performed by biochemical tests. Antibiotic sensitivity by disc diffusion method and minimum inhibitory concentration (MIC) by agar dilution method were performed. The cell surface hydrophobicity (CSH) behavior of those strains and their ability to form biofilm on glass and propylene surfaces was evaluated in static and shake conditions. The effect of antibiotics on biofilm formation ability was also determined on the catheter surface. Results: From 80 positive cases, 35 isolates of Escherichia coli and 15 isolates of Klebsiella pneumoniae were selected for this research. The Maximum resistance and sensitivity of isolates were observed about amoxicillin and imipenem, respectively. All isolates with CSH higher than 70% showed better biofilm formation even though on propylene in shaking state. Treatment of culture with 0.5 MIC (μg/ml) and 0.25 MIC (μg/ml) of selected antibiotics significantly reduced the adhesion ability of isolates. Conclusion: The survey therefore came to the conclusion that similar researches should be continuously repeated in different medical centers to test antimicrobial susceptibility as well as diagnosing and quantifying biofilm infection which surely achieved data help to find appropriate therapeutic way against UTI in pregnancy. [ABSTRACT FROM AUTHOR]

Background and Objective: Catheter Associated Urinary Tract infection (CAUTI) is one of the most prevalent hospital acquired infections which causes increased medical costs, hospital stay and mortality. Patients in critical care units are in a higher risk. The main purpose of the present study is the Identification of the effect of instruction and implementation of a preventive urinary tract infection bundle on the incidence of CAUTI. Materials and Methods: This was a before-after quasi-experimental study. 330 patients were included (185 patients in before and 145 in after the intervention). In both phases, the incidence of CAUTI, compliance with principles of CAUTI prevention, urinary catheter utilization and indications of catheter insertion were evaluated. CAUTI was identified based on the Center for Disease Control and Prevention/ National Healthcare Safety Network (CDC/NHSN) criteria with the online INICC software. Interventions included the instruction of the bundle to all health care workers in selected intensive care units and implementing interventions to improve facilities required for the implementation of the bundle. Results: No significant decrease was seen in the incidence of the CAUTI after the intervention (3.2 v/s 1.36 in 1000 catheter-day, p<0.388). The most prevalent indication for urinary catheter utilization in both phases, were critical monitoring of urine output (80.16% and 72.26%, respectively). Before the intervention, 1.6 % of catheterized cases were labeled inappropriate by the physicians. This increased significantly to 5.5% after intervention (P<0.001). Before the intervention, 37.5% of the catheters which were labeled inappropriate were removed which increased to 42/4% after the intervention insignificantly (P<0/709). From the 88 hours of compliance monitoring. The number of observed noncompliance cases before the intervention, which was 1941, decreased significantly after the intervention (P<.001). Conclusion: This study revealed that although instruction and implementation of the preventive bundle reduced CAUTI, this reduction was not significant. Future studies should be conducted with larger sample sizes and in longer periods. The most prevalent criterion for urinary catheter utilization was the need for critical monitoring of urine output. Instruction of the bundle reduced noncompliance with principles of urinary tract infection control. [ABSTRACT FROM AUTHOR]

Background: In spite of many reports on sickle cell disease, to our knowledge frequencies of nephrologic complications are not well defined especially in sickle thalassemia. The aim of this study was to assess the nephrologic complications of sickle cell syndrome. Methods: This is a cross sectional study, including all of the patients with sickle cell syndromes (97 cases) in hematology-oncology clinics of Shiraz University of Medical Sciences. A complete history taken and physical examination was performed. Blood and urine samples were sent for different tests including micro albuminuria and Cystatin C to measure glomerular filtration rate. Results: Ninety seven patients with mean age of 8.5 ± 3.4 years (55.4% males) were divided into three groups; 30 cases with sickle cell disease, 31 patients with sickle cell trait, and 36 cases with sickle thalassemia. Enuresis was present in 20 (22.9%) patients > 5 years. Significant proteinuria was not observed, but micro albuminuria was found in 14 (14.4%) patients. GFR was in normal range when calculated with creatinine clearance, but glomerular hyper filtration was present in 5.2% by Cystatin C formula. Mean serum creatinine was in low normal range (0.5 ± 0.1) but mean serum Cystatin C (0.9 ± 0.1) was higher than the normal range especially in Sβ patients (P = 0.023). Conclusions: In contrast to other reports, at least in the first two decades of life significant renal complications including renal failure and proteinuria were unusual in our patients with sickle cell syndrome. [ABSTRACT FROM AUTHOR]

Aim The association of sodium (Na) and potassium (K) intake with blood pressure ( BP) is an ongoing debate, especially in central Iran. We aimed to examine the mean Na and K intake, major sources of Na and the relationship between BP and dietary and urinary Na and K. Methods This cross-sectional study was performed in central Iran in 2013-2014. A total of 796 non-hypertensive adults aged >18 years were randomly recruited. The semi-quantitative food frequency questionnaire was used to assess dietary Na and K intake. Moreover, 24-hour urine samples were collected to measure 24-hour urinary Na ( UNa) and K ( UK) as biomarkers. BP was measured twice on each arm using a standard protocol. Results The mean Na and K intake were 4309.6 ± 1344.4 and 2732.7 ± 1050.5 mg/day, respectively. Table and cooking salt were the main sources of Na. Odds ratio ( OR) (95% confidence interval ( CI)) of the crude model in the highest quartile of UNa indicated a significant association with the higher risk of prehypertension ( OR (95% CI): 2.09 (1.09-4.05); P for trend = 0.007). After adjustment for potential confounders, prehypertension was significantly associated with increasing dietary Na/K ratio ( OR (95% CI): 1.28 (1.01-1.57); P for trend = 0.046) and UNa/ UK ratio ( OR (95% CI): 2.15(1.08-4.55); P for trend = 0.029). Conclusions Increasing dietary and urinary Na/K ratios and UNa were associated with elevated BP and prehypertension occurrence. These findings support the necessity of developing a salt reduction programme in our country. [ABSTRACT FROM AUTHOR]

The color of urine is an important factor in urine examination, which can help physicians differentiate various diseases. Today, it is known that certain dyes, drug intoxications, and diseases can induce green urine discoloration. In the view of traditional Persian medicine, which is based on humoral medicine, green urine discoloration is generally referred to the dominance of coldness in the body. In fact, it is considered to be a result of a special kind of humoral imbalance and fluid depletion or retention in the human body. Persian scholars believed that green urine could be an indicator of intoxication or a predictor of an imminent spasm or convulsion in pediatric patients. Further investigations could result in finding new diagnostic scales of urine color based on the teachings of traditional Persian medicine. [ABSTRACT FROM AUTHOR]

Hematuria is one of the most important clinical manifestations, dating back in antiquity to more than a thousand years ago. In this paper, we tried to give a brief history of hematuria in Persian medicine and compare its similarities with Modern medicine. The importance of this issue is to give a better cognition of hematuria in the Persian medicine viewpoint in comparison with Modern medicine and also to understand the antiquity of hematuria, using simple and accessible therapies, provide a background for further studies in this field, and ultimately help improve Modern medicine in order to have a better treatment package, along with managing the costs. [ABSTRACT FROM AUTHOR]

Background: Childhood masturbation (CM) is considered a variant of normal sexual behavior; however, it is commonly misdiagnosed as epilepsy and movement disorders. As the first study from Iran, we analyzed a large population of infants and children with CM in a case-control study and evaluated the value of mucus in urine analysis as an alternative diagnostic tool for CM. Methods: A total of 623 children referred to the Pediatric Neurology Clinic of Imam Khomeini Hospital for an evaluation of seizure or movement disorders were studied between 2008 and 2011. Totally, 359 children were found to have masturbatory behaviors (Group A) and the rest (264) were assigned to Group B. CM was diagnosed by direct observation. Collected data comprised demographic characteristics, clinical and neurodevelopmental examinations, laboratory findings (particularly urine analysis), and electrocardiography. Results: The age of the children with CM was below 12 years old, and the girl-to-boy ratio was 7:1. Mucus in urine was positive in 357 (99.44%) children in Group A and 22 (8.3%) in Group B (P<0.001). A significant correlation was found between the presence of mucus in urine and masturbatory behaviors (P<0.001). Conclusion: Our findings suggest that the presence of mucus in urine can be used as an alternative laboratory test in children with CM below 12 years old and even in infants (≤24 months old). Further studies are needed to confirm the results. [ABSTRACT FROM AUTHOR]

Objective The first line-screening test for mucopolysaccharidosis is based on measurement of urinary glycosaminoglycans. The most reliable test for measurement of urine glycosaminoglycans is the 1,9-dimethyleneblue colorimetric assay. Biological markers are affected by ethnical factors, for this reason, the World Health Organization recommends that the diagnostic test characteristics should be used to determine results for different populations. This study determines the diagnostic value of 1,9-dimethyleneblue tests for diagnosis of mucopolysaccharidosis type I patients in Iran. Materials & Methods In addition to routine urine analysis, the qualitative and quantitative measurements of urine glucosaminoglycans were performed with the Berry spot test and 1,9-dimethyleneblue assay. Diagnostic values of the tests were determined using the ROC curve. Results Urine total glycosaminoglycans were significantly higher in male subjects than in female subjects. Glycosaminoglycan concentration was markedly decreased in specimens with elevated white blood cell and epithelial cells count. Using a cut-off level of 10.37 mg/g creatinine, sensitivity, and specificity were 100% and 97.22%, respectively, for a 1,9-dimethyleneblue colorimetric assay. Conclusion Urine glycosaminoglycans concentration significantly differs in our studied population. In addition to determine diagnostic validity of the 1,9-dimethyleneblue test, our results demonstrate the usefulness of measuring glycosaminoglycans for early screening of mucopolysaccharidosis type I Iran. [ABSTRACT FROM AUTHOR]

Background: The first step in diagnosis of diabetic nephropathy is measurement of albumin in a spot urine sample. The aim of this study was assessment of the accuracy of urinary albumin to creatinine ratio (UACR) in random urine specimens (RUS) for microalbuminuria and macroalbuminuria screening in Iranian diabetic patients. Methods: A total of 200 diabetic patients participated to our study. 24 h timed urine specimens followed by RUS were collected. 24-h urine albumin excretion (24-h urinary albumin excretion (UAE)) and UACR in RUS were measured. Data were analyzed by Pearson's correlation, receiver operating characteristic (ROC) curve and McNemar test. Results: A total of 165 patients finalized the study. Pearson's correlation of coefficient for 24-h UAE versus UACR was 0.64. The area under ROC curve for UACR was 0.83 in microalbuminuria and 0.91 in macroalbuminuria. The cutoff point of 30 mg/g in UACR method had 86% sensitivity and 60% specificity for microalbuminuria screening and cut-off point of 300 mg/g had 75% sensitivity and 99% specificity for macroalbuminuria screening respectively. Conclusions: UACR in RUS showed acceptable performance as a screening test for diagnosis of both micro and macroalbuminuria in Iranian diabetic patients. [ABSTRACT FROM AUTHOR]

Background: Evaluation of treatment programs in addiction field is a prerequisite to improve the quality of care. This study aimed to investigate the effectiveness of Therapeutic Community (TC) program in Iran. Methods: Individuals who had voluntarily enrolled in the TC center within a period of seven years, from early 2005 to late 2011, entered the study. Those who successfully completed the 14-week residential course were considered as 'completers'. They were subsequently called in for urine test and interviews using Maudsley Addiction Profile. Urine test was conducted to determine if they were positive for heroin, opium, methadone, methamphetamine, bupronorphine, hashish, and tramadol. Results: A number of 378 individuals with mean (±SD) age of 32.5 ± 7.8 enrolled in the TC program during the study period, 240 individuals of whom completed the 14 weeks course (69.0%). At the end of the sixth year, 22% of the participants were in abstinence. Physical and mental health in abstainers proved to be of better conditions than those of non-abstainers (P<0.05). Conclusion: Considering the TC outcome in other countries, it seems that TC maintains an acceptable effectiveness in Iran. Prospective controlled studies are warranted to investigate the outcomes in more details. [ABSTRACT FROM AUTHOR]

High concentrations of arsenic were determined in sediments from the Kouhsorkh area, Khorasan province, NE Iran. The main rock formations in the area consist of Tertiary volcanic rocks as Tuffaceous sandstone, polymictic conglomerate and andesite. Furthermore, some As-Sb-Au mineralization occurred in this area. Concentrations of arsenic in sediments were determined to range between 4.2 and 268.2 ppm, exceeding US EPA () limits. It seems that young volcanic activity is one of the most important factors for arsenic contamination in this area. The first stage of this medical geology study was done at 2 villages in the Kouhsorkh area in which the arsenic concentration in water is high. People in this residential area suffer from skin diseases including hyperpigmentation, hypopigmentation, keratosis on head, hands, and feet. The 24-h urine specimens were tested for arsenic, the level of total arsenic in urine were determined to range between 13.66 and 75.92 μg/l day, exceeding permissible limits from 5 to 40 μg/day. More systematic studies are needed to determine the link between As exposure and its related diseases. [ABSTRACT FROM AUTHOR]

Nocturnal enuresis is a common problem among children. Hypercalciuria has been proposed as an important etiology of bedwetting. We investigated the incidence of hypercalciuria among children with nocturnal enuresis and age- and sex-matched healthy controls. In this case-control study 118 children with nocturnal enuresis and 100 age-, sex-, and educational district-matched healthy controls were recruited. Urine samples were obtained from each subject twice: immediately after awakening and 2 hours later at school. Urinary calcium and creatinine levels were measured and the subjects with a urinary calcium/creatinine ratio more than 0.2 were considered as hypercalciuric. Serum Ca, P, Na, K, and PTH levels were measured for all hypercalciuric subjects. The mean urine calcium to creatinine ratio in the second urine sample was 0.070±0.06 mg/mg and 0.050±0.046, respectively in the case and control groups (P=0.008). There were 12/118 and 3/100 hypercalciuric subjects in the case and control groups respectively (P=0.032). The serum Ca, P, Na, K, and PTH levels were in normal range in all hypercalciuric subjects. In our study there was a significant difference in the frequency of hypercalciuria among children with nocturnal enuresis and healthy controls, so we can suggest adding the measurement of urine electrolytes especially the calcium level in patients with nocturnal enuresis [ABSTRACT FROM AUTHOR]

Introduction: BK polyomavirus (BKV) as a member of polyomavirus family is prevalent in the human population. BKV persists in renal tissue after asymptomatic infection in childhood. The reactivation of BKV in renal transplant recipients sometimes can lead to BKV associated nephropathy. BKV isolates are classified into four serologically distinct subtypes. Present study was carried out to investigate the distribution pattern of BKV subtypes in Iranian Turkish renal transplant recipients. Materials and Methods: Urine samples from 12 kidney transplant recipients infected with BKV were analyzed by RFLP-PCR technique for classification of subtypes. Results: Our analysis showed that all samples were infected with BKV type I. BK virus types II, III, and IV were not detected in our patients. Conclusions: Based on the results of the present study, BKV subtype I was the most frequently detected subtype in renal transplant recipients. To our knowledge, the present study provides the first data regarding distribution of BKV subtypes in Iranian renal transplant recipients. [ABSTRACT FROM AUTHOR]

Background: Data on the effect of lifestyle intervention programs on salt intake and blood pressure in developing countries are scarce. This study aimed to assess the impact of a healthy lifestyle community-based trial on salt intake and blood pressure among a representative sample of normotensive Iranian adults. Materials and Methods: We compared the data for salt intake, urinary sodium levels and blood pressure from three cross-sectional surveys in time points of 1999, 2001-2002 (beginning of the community interventions), and 2007 (after the community trial) for normotensive adult population of Isfahan, Iran in the framework of Isfahan Healthy Heart Program. Using multi-stage cluster sampling method, one of the family members at each household was randomly selected with Iranian adult population as a target. Dietary salt intake was estimated based on 24 hour urinary sodium levels. Systolic and diastolic blood pressures were measured according to standard methods. Results: Dietary sodium intake and urinary sodium levels as well as systolic and diastolic blood pressure were significantly decreased during the 9-year study period. Unlike systolic and diastolic blood pressures that had a consistent decrement between 1999 and 2007, dietary sodium intake and urinary sodium levels were slightly raised from 1999 to 2000-2001 and then reduced between 2001-2 and 2007 evaluations. The same findings were reached when data were analyzed separately by gender or weight status. Conclusions: A lifestyle community trial was effective in controlling the escalating trend of blood pressure and salt intake in Iranian population. It can be considered as a model to be adopted in other developing countries. [ABSTRACT FROM AUTHOR]

Background and purpose: Due to the advantages of laparoscopic donor nephroctomy, such as maintaining cosmetic appearance, less post-operative pain, rapid rehabilitation, and less surgical scar, it has become a good alternative to open donor nephroctomy. No study has yet been done to compare the clinical consequences of open and laparoscopic donor nephroctomy in Iran. Materials and methods: This was a cross-sectional study conducted in Hashemi Nejad Hospical in Tehran. One hundred and twenty one kidney donors operated in this hospital were studied. Among them, 67 had experienced open and 54 had undergone laparoscopic donor nephroctomy. The amount of creatinine, GFR, and urine volume of the two groups were compared. Results: Warm ischemic time and hospitalization were significantly longer in the group with laparoscopy operation (P<0.05). Also the urine volume was significantly more in those undergone open donor nephroctomy (P<0.05). Moreover, the GFR index was significantly higher in the open donor nephroctomy group during the first two weeks after transplant (P<0.05). Conclusion: According to the findings of this study, it can be concluded that laparoscopic donor nephroctomy is a practical and safe method; therefore, it is recommended to apply this method for such cases. [ABSTRACT FROM AUTHOR]

Background: Lead (Pb) brings about a variety of cognitive, mental, renal, and blood system disorders by inducing oxidative stress. The aim of this study is to compare blood and urine parameters in the workers exposed to Pb and zinc (Zn) with those in the control group. Materials and Methods: An analytical cross-sectional study was conducted with a total number of 134 subjects. The case group included 67 male workers with the age range of 22-65 who had at least worked a minimum of one work shift for two years in the Zn-Pb mine located in the southwest of Arak, Iran. Control subjects consisted of 67 farmers of a village near the mine who had no history of occupational exposure to Pb, Zn, and other metals. Mental disorders were evaluated through the standard Scl-90-R while cognitive disorders were evaluated via the Mini Mental Status Examination (MMSE). Results: The mean level of blood and urine parameters did not reveal significant differences between the two groups. The mean scores of physical complaints, anxiety, and aggression scales were significantly higher in the case group than the control (p<0.05), whereas the mean scores on MMSE did not reveal a significant difference between the two groups. Conclusion: The oxidative stress of Pb led to mental disorders; as a result, the mine workers suffered from more psycho- pathology and are in need of greater care. Due to the impacts of Pb and Zn, the proper use of safety equipments and taking daily showers can reduce the risk of absorption of toxic agents and their subsequent hazards for workers. [ABSTRACT FROM AUTHOR]

Burns increase the metabolic demands of the body and can lead to severe weight loss and increased risk of death. Early enteral support is believed to improve gastrointestinal, immunological, nutritional and metabolic responses to critical injury; however, this premise is in need of further substantiation by definitive data. This research aimed to examine the effectiveness and safety of early enteral feeding in paediatric patients suffering from burns. Materials and methods: This clinical trial was carried out with a total number of 688 children with burns hospitalised in the Burn Department across a 2-year period (September 2002–September 2004). The subjects were randomised into two groups. A total of 322 patients received only intravenous resuscitation, in accordance with current treatment protocols, in the first 48h and were considered as the late enteral nutrition group (LEN group); 366 patients were nourished early enteral nutrition group (EEN group), such that both groups received similar amounts of fluid in the first 48h. Initiation of enteral nutrition commenced between 3 and 6h following the burn. The patients were kept in the unit until they were discharged. Wound management did not vary between groups. Results: In our study, the mean age was 5±3 years in the LEN group and 5±3.5 years in the EEN group. Hot liquids were the most common cause of burns in both groups. The mean percentage of burn was reported as 20±13 in the LEN group and 22±15 in the EEN group. Mean duration of hospitalisation was 16.4±3.7 days in the LEN group and 12.6±1.3 in the EEN group for cured patients (P <0.05). A total of 40 patients (12%) in the LEN group and 31 patients (8.5%) in the EEN group expired (P <0.05). Conclusion: Our research showed that EEN decreases duration of hospitalisation and mortality in children with burns. [Copyright &y& Elsevier]

Abu Bakr Mohammad Ibn Zakariya Razi, known in the west as Rhazes (865 to 925 AD), was born in the ancient city of Rayy, near Tehran, Iran. He was a renowned physician in medical history and not only followed Hippocrates and Galen, but also greatly extended the analytical approach of his predecessors. Based on the existing documents, he was known as the most distinguished character in the world of medicine up to the 17th century. A great number of innovations and pioneering works in the medical science have been recorded in the name of Rhazes. His fundamental works in urology as part of his research in the realm of medicine have remained unknown. Pathophysiology of the urinary tract, venereal diseases, and kidney and bladder calculi are among his main interests in this field. He also purposed and developed methods for diagnosis and treatment of kidney calculi for the first time in medical history. He also presented a very exact and precise description of neuropathic bladder followed by vertebral fracture. He advanced urine analysis and studied function and diseases of the kidneys. Rhazes recommendations for the prevention of calculi are quite scientific and practical and in accordance with current recommendations to avoid hypercalciuria and increased saturation of urine. Rhazes was not only one of the most important Persian physician-philosophers of his era, but for centuries, his writings became fundamental teaching texts in European medical schools. Some important aspects of his contributions to medicine are reviewed. [ABSTRACT FROM AUTHOR]

In order to estimate the prevalence of opiate use and to cross-validate the current program of urine testing as the sole screening and detection method for finding opiate abusers* in Iran, urine samples of 1120 men with a mean (± SD) age of 46.6 (± 16.5) years referring to a large clinical lab for diagnostic and screening purposes in Kerman (the center of the biggest province in Iran) were assayed by anonymous, unlinked testing for opioid metabolites during 2004. The specimens were analyzed by an immunoassay screening test and a thin-layer chromatography (TLC) confirmation test. The initial screening test was positive in 28.8% (95% CI: 26.1-31.5) of cases (322 individuals), half of whom were confirmed by TLC. As a whole, 14.4% (95% CI: 12.4-16.6) of urine samples were positive for opioid metabolites. Although individuals referring to clinical labs do not exactly represent the general population, according to relatively high figures achieved in this study we suggest revising the urine test as the sole screening and detection method for finding Iranians who use opiates for non-medical reasons. Research is needed to further pursue these findings. [ABSTRACT FROM AUTHOR]

The article discusses the study which compares benzene exposure and urinary levels of trans,trans-muconic acid (t,t-MA) in taxi drivers and petrol station workers in Iran. It states that the concentration of benzene in the breathing zone of petrol station workers is 2-3 times higher than taxi drivers and 3 times greater than a threshold level recommended by the American Conference of Governmental Industrial Hygienists (ACGIH).

A pilot study to investigate the occurrence of 10 mycotoxins (deoxynivalenol, DON; 3-acetyldeoxynivalenol, 3-ADON; 15-acetyldeoxynivalenol, 15-ADON; fusarenon-X, FUS-X; diacetoxyscirpenol, DAS; nivalenol, NIV; neosolaniol, NEO; zearalenone, ZON; zearalanone, ZAN; T-2 toxin, T-2; and HT-2 toxin, HT-2) in esophageal cancer patients was performed with the urinary biomarkers approach in Golestan, Iran. Urine multimycotoxin analysis was performed by dispersive liquid–liquid microextraction and gas chromatography–tandem mass spectrometry (GC–MS/MS) analysis, and values were normalized with urinary creatinine (μg/g). Four mycotoxins, namely NEO (40%), HT-2 (17.6%), DON (10%), and HT-2 (5.8%), were detected in the analyzed urine samples. DON was only detected in the control group (5.09 μg/g creatinine), while T-2 (44.70 μg/g creatinine) was only present in the esophageal cancer group. NEO and HT-2 were quantified in both control and case groups, showing average of positive samples of 9.09 and 10.45 μg/g creatinine for NEO and 16.81 and 29.09 μg/g creatinine for HT-2, respectively. Mycotoxin co-occurrence was observed in three samples as binary (NEO/HT-2 and T-2/HT-2) and ternary (DON/NEO/HT-2) combinations, reaching total concentrations of 44.58, 79.13, and 30.04 µg/g creatinine, respectively. Further investigations are needed to explore a causal association between mycotoxin contamination and esophageal cancer. For this pilot study in Golestan, the low sample size was a very limiting factor. [ABSTRACT FROM AUTHOR]

Background: Current evidence regarding the prognostic relevance of urinary sodium-to-potassium ratio (Na-to-K ratio), as an indicator of diet quality is limited. This study was conducted to investigate whether urinary Na-to-K ratio could be related to habitual dietary patterns, in a general population., Methods: This study was conducted in the framework of the Tehran Lipid and Glucose Study (2014-2017) on 1864 adult men and women. Urinary Na and K concentrations were measured in the morning spot urine samples. Dietary intakes of the participants were assessed using a validated 147-item Food Frequency Questionnaire (FFQ) and major dietary patterns were obtained using principal component analysis. Mediterranean dietary pattern and Dietary Approaches to Stop Hypertension (DASH) score, were also calculated. Multivariable-adjusted linear regression was used to indicate association of dietary patterns and urinary Na-to-K ratio., Results: Mean (± SD) age of participants was 43.7 ± 13.9 years and 47% were men. Mean (± SD) urinary Na, K and the ratio was 139 ± 41.0 and 57.9 ± 18.6 mmol/L, 2.40 ± 0.07, respectively. Higher urinary Na-to-K ratio (> 2.37 vs. < 1.49) was related to lower intakes of vegetables (282 vs. 321 g/day), low-fat dairy (228 vs. 260 g/day) and fruits (440 vs. 370 g/day). Western dietary pattern was related to higher urinary Na-to-K ratio (β = 0.06; 95% CI 0.01, 0.16). Traditional dietary pattern, Mediterranean and DASH diet scores were inversely associated with urinary Na-to-K ratio (β = - 0.14; 95% CI - 0.24, - 0.11, β = - 0.07; 95% CI - 0.09, - 0.01, β = - 0.12; 95% CI - 0.05, - 0.02, respectively)., Conclusions: Spot urinary Na-to-K ratio may be used as a simple and inexpensive method to monitor diet quality in population-based epidemiological studies.

Background: As there are different views on the effects of aminophylline on neonatal renal function, we intended to observe the effects of aminophylline on renal dysfunction in neonates with prenatal asphyxia., Methods: This randomized trial was conducted in the Obstetrics and Gynecology Hospital, Tehran, Iran, from June 2016 to May 2017, in neonates with moderate to severe asphyxia during birth. Fifty-six neonates were divided randomly into two groups. The intervention group received one dose of 5mg/kg slow intravenous aminophylline injection and the placebo group received 2 mL/kg of intravenous 10% solution of dextrose saline during the first hour of life. They were monitored and compared for renal functional indices, electrolytes, and complications of asphyxia during the three days of life., Results: The mean of Cr (37.9 ± 8.8 vs 38.5 ± 9.4 and 20.8 ± 4.8 vs 30.1 ± 5.2 μmol/L), GFR (21.55 ± 4.7 vs 20.25 ± 4.4 and 30.8 ± 7.1 vs 20.1 ± 6.5 mL/minute/1.73 m 2 ), Na (135.1 ± 12.4 vs134.5 ± 11.2 and 128.9 ± 11.5 vs 134.2 ± 10.9 mEq/L), and urine output (98.2 ± 25 vs 96.8 ± 23 and 148.7 ± 35 vs 108.8 ± 20 cc) were in the aminophylline treated and placebo group on the 1st and 3rd days, respectively. The mean difference of Cr (-9.3 (-8.9; -9.7) μmol/L); ( P = 0.02), GFR (10.7 (10.1; 11.3) mL/minute/1.73 m 2 ) ( P = 0.009), Na (-5.3 (-5.9; -4.7) mEq/L) ( P = 0.002), and urine volume (39.9 (24.9; 54.9) cc) ( P = 0.001) presented statistically significant differences on the third day between the intervention and placebo group., Conclusion: Aminophylline was effective in preventing renal dysfunction in neonates with asphyxia. Neonates who received aminophylline indicated a significant improvement in GFR and urine output on the first day of life., (© 2020 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.)

In low-income and middle-income countries such as Iran, smoking is becoming increasingly popular, especially among young people. This has led to additional exposure to a variety of substances, including metals which may exert a toxic influence and lead to severe diseases. In order to evaluate the influence of smoking on metal concentrations, a case-control study of levels of metal in urine was carried out in smokers (n = 64) and non-smokers (n = 35) from the city of Birjand (Iran). They were divided according to their age and socioeconomic status. Concentrations of cadmium (Cd), cobalt (Co), chromium (Cr), copper (Cu), iron (Fe), nickel (Ni), lead (Pb), and zinc (Zn) were measured using ET-AAS. We found higher concentrations of Cd (0.03 vs. 0.12 μg/L), Co (0.6 vs. 1.22 μg/L), and Cr (14.00 vs. 18.17 μg/L) in the urine of smokers. Age and occupation are factors that also influence the levels of metals. Young smokers demonstrate higher Cd and Pb levels than other age groups. It would also appear that public sector workers and self-employed are the sectors most susceptible to high levels of metals.

Parabens are widely used as preservatives in cosmetics, medicines, and foods due to its antimicrobial properties. Concerns have been raised regarding the estrogenic activity and potential endocrine disruption effects of parabens. Studies on monitoring of paraben exposure in the Iranian population are very scarce. This study was carried out to measure urinary concentrations of parabens, to estimate their daily intake, and to identify some of the sociodemographic factors affecting exposure to these compounds. The concentrations of methylparaben (MP), ethylparaben (EP), propylparaben (PP), and butylparaben (BP) were measured in urine samples collected from 95 Iranian pregnant women by gas chromatography mass spectrometry. The highest median concentration was 87.0 μg/L for MP, followed by PP, EP, and BP with median concentrations of 15.6, 9.64, and 8.57 μg/L, respectively. Except BP, the urinary concentrations of other parabens were comparable to those in other countries. Also, the highest daily intake was related to MP (median = 16.5 μg/kg-BW/day), which is less than the acceptable daily intake (ADI). A significant positive correlation was observed between the measured parabens. Significant negative associations were observed between age and BP, BMI and EP as well as parity and PP. On the other hand, income and smoking were significantly positively associated with MP, BP and EP, BP, respectively. The urinary MP and BP concentrations were higher among the subjects with diploma education (P = 0.003 and P = 0.006, respectively), and during the spring, urinary MP concentration was higher than other seasons. The results showed that Iranian pregnant women are more prone to parabens and their urinary paraben concentrations are associated with sociodemographic factors. This result could serve as a basis for evaluating the rate of exposure of the Iranian population to parabens in future studies.

Objective: To assess agreement between established methods of estimating salt intake from spot urine collections and 24 h urinary Na (24hUNa) and then to develop a valid formula that can be used in the Iranian population to estimate salt intake from spot urine samples., Design: A validation study. Three spot urine samples were collected (fasting second-void morning; afternoon; evening) on the same day as a 24 h urine collection. We estimated 24hUNa from spot specimens using the Kawasaki, Tanaka and INTERSALT equations. Two new formulas were developed, the Iran formula 1 (Iran 1) and Iran formula 2 (Iran 2), based on our population characteristics., Setting: Iranian adults recruited in 2014-2015., Participants: Healthy volunteer adults aged ≥18 years., Results: With all three spot urine specimens, predicted population 24hUNa was underestimated based on the INTERSALT equation (-469 to -708 mg/d; all P < 0·05) and conversely overestimation occurred with the Kawasaki equation (926 to 1080 mg/d; all P < 0·01). The Tanaka equation produced comparable estimates to measured 24hUNa (-151 to 86 mg/d; all P > 0·49). The newly derived formulas, Iran 1 and Iran 2, showed less mean bias than the established equations (Iran 1: 43 to 80 mg/d, all P > 0·55; Iran 2: 22 to 90 mg/d, all P > 0·50)., Conclusions: In this Iranian sample, the Tanaka equation and newly derived formulas produced group-level estimates comparable to measured 24hUNa. The newly developed formulas showed less mean bias than established equations; however, they need to be tested for generalization in a larger sample.

The diagnosis of leishmaniasis relies mainly on the use of invasive processes, to collect the biological material for detecting Leishmania parasites. Body fluids, which can be collected by non-invasive process, would greatly facilitate the leishmaniasis diagnosis. In the present study, we investigated the potency of urine immunoblotting to diagnose cutaneous and visceral leishmaniasis and we compared with routine molecular methods. A total of 80 samples, including 40 sera and their 40 corresponding urine samples were collected from 37 suspected patients with cutaneous and visceral leishmaniasis, and 3 healthy individuals (as control), in Ilam and Ardabil provinces of Iran. All sera and urine samples were analyzed, using immunoblotting. The confirmation of leishmaniasis infection was performed, using conventional and quantitative PCRs as well as by sequencing the amplicons. Among 37 suspected patients, 23 patients presented cutaneous lesions (CL) and 14 exhibited clinical symptoms reminiscent of visceral leishmaniasis (L. infantum). Among cutaneous patients, 15 were positive for zoonotic cutaneous leishmaniasis (L. major), and eight for anthroponotic cutaneous leishmaniasis (L. tropica). Molecular quantification of Leishmania parasites was performed on sera, urines and cutaneous biopsies of CL and VL patients, demonstrating that parasite load is lower in urines, compared to sera or biopsy. DNA can be detected in 20 out of 23 (86.9%) CL urine samples and in 13 out of 14 (92.8%) VL urine samples. Immunodetection analysis demonstrates that 22 out of 23 (95.6%) sera from CL patients and all patients suspected with VL are positive. For urine samples, 18 out of 23 (78.2%) urine of CL patients and 13 out of 14 (92.8%) urine of VL patients were positive, using Western blot. Therefore, immunodetection and molecular analysis using urine samples can be used as a diagnostic tool for surveying cutaneous and visceral leishmaniasis., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Background: Malaria can be diagnosed in saliva and urine using mitochondrial PCR detection of Plasmodium DNA., Methods: Blood, saliva and urine were collected from 99 febrile patients referred to health centers in Sistan and Baluchestan Province, southeastern Iran, from May to November 2011. The mitochondrial cytochrome b gene of Plasmodium falciparum and Plasmodium vivax was targeted in saliva, urine and blood samples using nested PCR., Results: Nested PCR proved to be more sensitive than microscopy for the diagnosis of sub-microscopic and mixed-species infections. The results of nested PCR amplifications of saliva and urine samples showed the same specificity of 97% and sensitivity of 91% and 70%, respectively. Nested PCR amplifications of saliva samples and microscopy showed the greatest area under the receiver operating characteristic (ROC) curve and were more accurate than nested PCR amplifications of urine samples., Conclusion: Nested PCR amplification of saliva samples showed good levels of detection of mitochondrial Plasmodium DNA as compared to nested PCR of blood (к=0.84; AUC=0.94), which was used as a reference standard. Based on the results of nested PCR as well as the advantages of saliva sampling, we suggest that saliva could be an alternative to blood, in malaria diagnosis, in cases where repeat sampling is required. Further studies are needed to validate these findings., (© The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objectives: Considering the relation between prematurity andasphyxia and also renal failure in neonates, the aim of this study was to determine the effect of aminophyllinein urine and serum indices of renal failure and consequently its prevention, in Premature Infants with asphyxia in Esfahan-lran., Methods: In this descriptive clinical trial study, 22 preterm neonates diagnosed with perinatal asphyxia in neonatal ward of Shahid Beheshti hospital, during 2009.The participants were randomized in two intervention and placebo groups. They randomized to receive a single dose of aminophyiline (5 mg/kg) or placebo of 5% dextrose water for injection (5 cc/kg) during the first hour of life. Renal function was assessed by GFR, beta2-microglobulin (beta2M), N-acetyl-glucosaminidase (NAG) serum creatinine and electrolytes level measurement, during the 1st, 4th and 7th day of life, in two studied groups. The results compare between the two groups before and after intervention., Results: Mean of urine output, was significantly higher in neonates who received aminophylline (P < 0.05).Mean of 132M and NAG 24 hours after intervention was not significant in the two groups of asphyxiated preterm neonates (P > 0.05).GFR was significantly higher in neonates who received aminophylline on 4th day of life (P < 0.05) and it had trend to be significantly high on 7th day (P = 0.05) and was not significantly high on 1st day (P > 0.05) comparing with control group. The most common pathophysiology of renal failure was prerenal., Conclusion: Aminophylline could prevent renal dysfunction in preterm neonates with asphyxia. Neonates who received aminophylin on the first day of life indicated a significant improvement in GFR and urine output.

The prevalence of extended-spectrum beta-lactamase (ESBL) production by consecutive, non-repeated Escherichia coli isolates from hospitalised patients was determined over the period from July 2005 to November 2006. A total of 201 E. coli were isolated from various clinical specimens, 135 (67.2%) of which were confirmed as ESBL-positive using the combination disk synergy test. By univariate analysis, male sex, intravascular or urinary catheterisation, recent surgery or hospitalisation and isolation of E. coli from wound or respiratory tube specimens were found to be risk factors for acquisition of resistant bacteria (chi(2) test, P<0.05). However, binary logistic multivariate regression analysis confirmed that isolation of E. coli from urine samples of either males in any hospital ward (odd ratio (OR) 7.52, 95% confidence interval (CI) 1.21-47.62; P=0.031) or patients with prior surgery (OR 13.16, 95% CI 1.81-100.00; P=0.011) were significantly associated with ESBL production. Imipenem, amikacin and piperacillin/tazobactam were found to be highly active against ESBL-positive isolates in vitro (100%, 91.1% and 85.2% susceptibility, respectively). They showed co-resistance with other antibiotics such as fluoroquinolones, gentamicin and trimethoprim/sulfamethoxazole. Of the 135 ESBL-positive isolates, 22 (16.3%) appeared to be of the CTX-M type based on a phenotypic determination method.

Background: As the voiding habits of Iranian children differs from other children because of some cultural and religious considerations, we aimed to establish normal reference values of urinary flow rates in Iranian children between 7 to 14 years of age., Methods: Eight hundred and two uroflowmetry studies were performed on children with no history of a renal, urological, psychological or neurological disorder, between the ages 7 and 14. Five hundred twenty five studies from 192 girls and 335 boys were considered in this study excluding the staccato/interrupted voiding pattern or voided volume less than 20 ml. The voiding volume, the maximum and average urinary flow rates were extensively analyzed., Results: The maximal and average urine flow rate nomograms were plotted for both girls and boys. Mean maximum urine flow rate was 19.9 (ml/sec) for boys and 23.5 (ml/sec) for girls with a mean voided volume of 142 (ml) for boys and 147 (ml) for girls. Flow rates showed a close association with voiding volume in both sexes. The maximum and average flow rates were higher in girls than in boys, and they showed a significant increase in flow rates with increasing age, where boys did not. The mean maximum urine flow rates (19.9 ml/sec for boys and 23.5 ml/sec for girls) were found to be higher in this study than other studies., Conclusion: Nomograms of maximal and average flow rates of girls and boys are presented in centile form, which can help the physician to evaluate the response to medical or surgical treatment and be useful for the screening of lower urinary tract disturbances in children, for a wide range of voided volumes.